My story - minor bends

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zambi

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Location
Luton, UK
# of dives
0 - 24
Hi everybody,

I just thought I'd take a couple of minutes to share with you all my story of getting bent. My symptoms actually arose from a completely innocuous dive, and my pre-concentions about DCS from my training caused me to deny my condition and delay seeking treatment. So I think it's worth re-counting the story for general info.

A couple of weeks ago I went diving in Zadar, Croatia. I had a couple of beers the night before but nothing heavy. Unfortunately, the night before the dive I was kept awake by drunk obnoxious people in the youth hostel and so was a bit tired in the morning. Still, excited about the dive, we sailed 2 hours to the dive site early the next day. The only thing I can say about the dive is that having not dived for 6 months of so, I had a bit of pain descending above my right eye (sinus), but it went away so I thought nothing of it. The water was quite cold, and we did struggle a bit with the current. The dive master insisted that the interval between the dives was at least 1hr30, though I had barely warmed up, and my girlfriend and I estimate that the interval was 45 minutes between dives. Maximum depth of the dives was 14m and 17.2m respectively. There was hardly anything to drink on the boat - I realise in retrospect that I was dehydrated. I asked for a glass of water and was given a foul tasting cup from the boat's tanks.

That evening I felt a bit nauseous and hot and tired. We took an overnight bus to Trieste in Italy, during which I also didn't sleep well. The next day in Trieste, my back and shoulders and ears started to itch a lot. I presumed it was just seawater irritation. We took a tram up the hillside to the pine forest overlooking the city, and I felt distinctly ****ty, which was my first warning that my symptoms were dive related. I slept a little in the shade and took the next tram down. The same day, we travelled to Ljubljana (Slovenia). I began to feel very foggy and 'out of it' in the afternoon. Its quite hard to explain, but I felt sounds sounded far away and I was somewhat disconnected from my body. It was a real effort to concentrate or keep up with a conversation. I thought I was exhausted or run down, so just went to bed. I was ok when I woke up, but mid-morning the same symptoms re-occured. Concerned, I went to an internet cafe and searched for my symptoms. I found a threat on this site (http://www.scubaboard.com/archive/index.php/t-19093.html), I went straight to hospital, where many hours later I was diagnosed with DCI and treated for 2hr45 in a hyperbaric chamber. I was kept in overnight for observation and told to return if symptoms re-occurred. It was then that tingling and numbness in my legs began. Vertigo and diziness and confusion continued, but the main symptom of the hearing sensation went. I was discharged from hospital and didn't return the day after, as I had a flight back to England and didn't want my girlfriend to have to take time off work and go through the whole foreign hospital ordeal again.

A few days back in the UK and the confusion and tingling remained. I couldn't concentrate at work or remember things (like my computer password) from minute to minute. I went back to my local hospital and was referred to the London Hyperbaric Medicine Unit at Whipps Cross Hospital. It was a week to the day since my dives (the only ones this summer). They insited that in Slovenia I should have been treated with a 'table 6' treatment (4.5hrs+) instead of a table 5 (2hr15). I was given two 'table 5's' in London and discharged. It was decided that I had neurological symptoms in particular a 'postitive Romberg' (unable to balance with eyes closed).

It is now two days later, and other than a dull headache I feel much better. No more itching or confusion or diziness. I am concerned however about how dopey and 'out of it' I still feel. I tire very easily and still have trouble keeping up with any conversation without drifting off. This has always been a personality trait of mine but I think the incident and the late treatment has definately made it worse. Fingers crossed. I hope to be back at work on Monday.

Anyway, sorry this is so long. I just felt I should share this story, because as an AOW diver with 21 dives, I still didn't realise the bends could realistically occur from normal dives in which safety stops and all other procedures were followed correctly. If I had been able to identify my symptoms earlier, perhaps the story would have turned out differently?

If in doubt, check it out! Be safe.

Tom
 
Out of curiosity, what were your ascent rates each dive?

I'm sure dehydration and lack of sleep were contributing factors.

Cheers

Chris
 
Thanks for posting your experience.

Unless your dives were exceptionaly long or acompanied by very quick ascents it seems unlikely that you should have been hit.

However given the water temperature, dehydration, fatigue and perhaps a slight cold (sinus infection)... it is possible that these factors combined may have made off gassing difficult.

I might also consider a PFO as a possible source of your difficulty. I would be reluctant to dive again until I had sorted this out. The tables are really built for the general population... and as one who has been hit without a notable violation of the tables) I wonder if something else is at work.

I'm not a doc... and perhaps a call to DAN for a consultation might be inorder.

Thanks for your description of your experiences.
 
Hi again.
I didn't make a record of the exact ascent rate but for the latter half of the first dive we stayed close to the shore at around 5-7m. On the second, we came up gradually and did the safety stop. I know the factors I mentioned were contributors but I'm still struggling to understand what happened - I'm an active, fit and healthy 25 year old!
 
Did the overnight bus ride to Trieste involve a significant gain in altitude? If so, you may have an incident which is more related to violating the flying after diving guidelines.
 
Let's review this a bit...

From what you have written, it appears your second dive was deeper than your first. While there is some disagreement, most dive professionals strive to make the second dive more shallow. That's point one.

You apparently went to higher altitudes after your two dives. You don't mention what the altitude was, but it seems from your writing that you ascended a hill.

You were tired and dehydrated on the dives. Both of which can cause problems.

And while still sufferin symptoms you took a flight.

Hmmm.....

Just wondering, where you checked for anything other that possible DCS at the hospitals?

Jeff
 
I'm sorry for your experience. I'm betting the severe dehydration had a lot to do with it. You might try teaching yourself to dive with a camelback so that you can drink all the time and avoid dehydration when you get back to it. Also, I never go anywhere, ever without bottled water, especially in a foreign country.
I also learned in Africa that you have to check the seal on bottled water. Never realised before that in foreign, third world countries it's not unusual for people to refill bottles and sell in grocery store. My roommate in Africa had a son who nearly died of cholera on a trip to Africa from this.
Probably was a very, very bad idea to try flying shortly after decompression treatment. Didn't they give you a timetable on when you could fly again? Hope your symptoms get better. Neurological DCS is nothing to play around with.
 
Hi guys, thanks for your input. You're right, jtoorish, about the second dive being deeper than the first. I think what I learned is to stay more in control of my own dive more. Perhaps I was a bit passive in being led by the staff. It was a German dive shop - and they tend to have a great reputation for doing things by the book, so I guess I was just a bit too laid back in some respects!

I've done a bit of digging around and found that I went to 343m above sea level on the hillside in Trieste. That's obviously a little more than the 300m max, and I wouldn't have done that had I had a guidebook or any kind of prior knowledge about Trieste. Good point about crossing high altitude during the coach journey though, I'll look into that. You see what I will say in my defence (!) is that as my symptoms made me so dopey and 'out of it' I wasn't able to think actively enough about these things! :wink: I had two full medical examinations, 2 ECGs, 2 lung x-rays, 2 blood tests (normal and arterial - agony). They mentioned that they were trying to eliminate other causes but didn't say what they might be. Their English was not great. I was very grateful for their thoroughness though.

Dr Tracey - The Hyperbaric Unit in London I called from Slovenia suggested I come home, and that as I was 'stuck between a rock and a hard place' there was little choice - and that as it was over 48 hours since the dive flying would be fine. My insurance company then reacted like 'WHAT?? There's no way you can fly with those symptoms'. After my treatment in Slovenia, the team of doctors said I was free to fly that very day if I needed to, so I just went by that medical advice. I flew 5 days after my dive. Slovenia is in the EU btw and is famous for its mineral water! The German insisted they had 'gallons and gallons' aboard. I have since called him and was quite insistent that he should carry proper, PALATABLE drinking water, which he eventually admited.
 
Let's not forget that DAN classifies DCS/DCI hits as either deserved or undeserved hits. This is one of those instances that falls in the gray area between the two. Yes, Zambi probably followed proper diving procedures in the water but then violated proper procedures immediately after the dive by ascending above 300m. However, his symptoms appeared prior to his ascending above 300m. Will we ever know with any certainty whether this is a deserved or undeserved hit...probably not. Kudos to Zambi for having the courage to post his experience though!
 
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